Indications & Uses
Cynomin-H is indicated for:
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Adults and children may use the following dosage schemes. For Addisonian pernicious anaemia and other macrocytic anaemias without neurological involvement: the initial dose is 250 to 1,000 micrograms by intramuscular injection on alternate days for one to two weeks, then 250 micrograms weekly until the blood count returns to normal. The maintenance dose is 1,000 micrograms monthly. For Addisonian pernicious anaemia and other macrocytic anaemias with neurological complications: the initial dose is 1,000 micrograms by intramuscular injection on alternate days for as long as improvement continues. The maintenance dose is 1,000 micrograms monthly. For prophylaxis of macrocytic anaemia associated with vitamin B12 deficiency arising from gastrectomy, certain malabsorption syndromes, or strict vegetarianism: 250 to 1,000 micrograms monthly. For the Schilling test: an intramuscular injection of 1,000 micrograms of hydroxocobalamin is an essential part of this test.
Side Effects
Sensitisation to Cynomin-H is rare but it may present as an itching rash, chills, fever, hot flushes, nausea, and dizziness, and in exceptional cases as anaphylactic shock. Acneiform and bullous eruptions have also been reported, though rarely.
Cautions & Contraindications
Warnings & Precautions
Cynomin-H should not be given until the diagnosis has been confirmed, if at all possible. The dosage schedules above are usually adequate, but the blood should be checked regularly during treatment. If megaloblastic anaemia does not respond, folate metabolism should be looked into. Doses above 10 micrograms a day can produce a haematological response even in patients who are folate deficient, so giving it indiscriminately may mask the true diagnosis. Cardiac arrhythmias linked to hypokalaemia have been reported during the early stages of therapy, so plasma potassium levels should be monitored over this period.
Contraindications
Anaphylaxis; tobacco amblyopia.